Health Information Compliance Alert

Published on Fri May 12, 2006 PDF

Carriers bring more providers on board with clinical quality assurance.

President's orders: All insurers, providers and consumers are to adopt and be able to exchange electronic health records by 2014. President Bush's goal is certainly within reach--but the path to achieving it is littered with stones.

One of the biggest obstacles to progress is the source of patient information. Who should initiate a patient's EHR--the insurer, the physician or the patient? As claims processors, payers are equipped with plenty of patient data to get the ball rolling. But to convince providers to cooperate, they'll need to earn physicians' trust in their data's clinical quality.

Overcome Providers' Mistrust With Measurable ROI

Claims data is a rich source of patient information that's easy to mine and transform into a robust EHR prototype. Converting claims data into a viable EHR would spare doctors the time and expense involved in choosing their own EHR infrastructure--not to mention initiating the records themselves.

Benefits: Using payer-based health records (PBHR), a physician would have access not only to treatments he performed on a particular patient, but to treatments and consultations from other providers for that same patient. In addition, a working PBHR means that beneficiaries wouldn't have to rely on their own time, motivation and expertise to obtain a working EHR. As an added value, benes could instead obtain their own working EHRs directly from insurers to update at will.

But for all their attempts to take Bush's EHR initiative by the reins, many insurers are bumping up against rigid physician objection. "[Claims data] is not designed or intended for the evaluation of clinical quality," Illinois State Medical Society president Dr. Craig Backs recently told the Chicago Sun-Times.

But having some information has got to be better than having none, counters Kristel Schimmoller, product marketing vice president for health care software vendor MEDecision. With the bulk of data that payers have available, they can start seeding the market with information--the next step is to demonstrate the return on investment providers will receive at the point of care, Schimmoller tells Eli.

Thieves Swipe Home Care Employees' Laptops

Patient privacy lapses continue to dog Portland, OR-based Providence Health System.

In December, a thief stole 365,000 computer patient records from a Providence Home Services employee's vehicle, triggering investigations and lawsuits. Now thieves in two car break-ins stole data on 122 home care and hospice patients in Snohomish County, WA from employees' laptops.

The employees weren't following company policy when they left the laptops in their cars unattended while they entered a patient's home and a store, respectively, The Oregonian newspaper reports.

Providence has offered free identity and credit restoration and monitoring services to every affected patient and is adding encryption to home care employees' laptops to lock out unauthorized users, the paper says.